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A Multimodal Imaging Analysis

Nika, Melisa MD; Kalyani, Partho S. MD; Jayasundera, K. Thiran MD; Comer, Grant M. MD, MS

doi: 10.1097/IAE.0000000000000496
Original Study

Purpose: To describe previously unreported clinical characteristics of persistent placoid maculopathy, suggest a pathogenesis of persistent placoid maculopathy using multimodal imaging, and provide evidence supporting high-dose immunosuppression for short-term management.

Methods: Retrospective case series.

Results: The cohort included 3 men with ages ranging from 55 years to 68 years. Persistent placoid maculopathy was bilateral in all 3 patients and characterized by recurrence and choroidal neovascularization in 1 patient. The median time to presentation was 3 months (range, 2–24 months), and follow-up was 8 months (range, 3–24 months). Previously unreported findings of far-peripheral lesions and optic nerve hyperfluorescence on fluorescein angiography were noted in separate individuals. In addition, findings from multimodal imaging supported an inflammatory pathogenesis of the inner choroid and the outer retina. Finally, all patients experienced substantial improvement to structural and functional measures in at least one eye within days to weeks of initiating high-dose corticosteroids (0.75–1 mg/kg/day).

Conclusion: Multimodal imaging suggests that persistent placoid maculopathy has an inflammatory pathogenesis that may affect the inner choroid with secondary changes to the retinal pigment epithelium and the outer retina. High-dose corticosteroids may provide short-term benefit.

Persistent placoid maculopathy is a rare bilateral maculopathy. Multimodal imaging supports an inflammatory pathogenesis. Treatment with high-dose corticosteroids may be beneficial.

Department of Ophthalmology, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan.

Reprint requests: Grant M. Comer, MD, MS, Department of Ophthalmology, W. K. Kellogg Eye Center, University of Michigan, 1000 Wall Street, Ann Arbor, MI 48105; e-mail:

Paper presented in part at the American Society of Retina Specialists Annual Meeting, Las Vegas, NV, August 25, 2012, and Macula Society Annual Meeting, Key Largo, FL, February 22, 2014.

None of the authors have any conflicting interests to disclose.

© 2015 by Ophthalmic Communications Society, Inc.